DeQuervain’s tenosynovitis is a very common cause of wrist pain. The wrist pain is located at the level of the wrist and near the base of the thumb. Most people think of a tendonitis as an “annoyance” at best. Don’t let this fool you; it is not uncommon to have patients present to clinic after being seen in the emergency room thinking they broke a bone in their wrist. DeQuervain’s tendonitis can be very painful.
The tendons that get inflamed are the same ones that extend the thumb. Patients frequently report that extension of the thumb is very painful. In mild cases splinting and over the counter anti-inflammatories can significantly help the pain or even completely resolve it. However, by the time most patients get to a physician they have already tried these treatments.
Your physician may recommend one of the above treatments if they have not already been attempted. If these treatments are ineffective a steroid injection or a small surgical procedure that decompresses the tendon may be indicated.
The surgical procedure is called release of the first dorsal compartment. It is done on an outpatient setting. It can be done under local anesthesia or while completely asleep. Most people elect to have a mild sedation. The surgery can be done through a very small incision usually measuring less than a centimeter (See image). At two weeks the stitches are removed and normal activity is begun. Most people are back to work in their splint the day after surgery